Ligature effect on wrist of a child.

A rubber band worn around a limb in an infant has the potential to cut through the tissues. The cutting potential of a rubber band is proportional to the strain within the band. A circumferential scar over the wrist with multiple discharging sinuses is the usual presentation. Such presentations should raise the suspicion of 'the rubber band syndrome'. A forgotten band migrates through the tissues and the skin epithelialises over it. As a result, continuity and function in the limb may be maintained, leading to misdiagnosis and wrong treatment. A high level of suspicion and treatment in the form of surgical removal and adequate debridement at first followed by formal reconstruction of deficits secondarily are required in the management of such patients.